Background: Smoking is a known risk factor of atherosclerosis, endothelial dysfunction, athermanous plaque rupture, unstable coronary syndrome and sudden cardiac death.Methods: The present study comprised 40 randomly selected healthy male hospital staff without a history of hypertension or cardiac or pulmonary disease. Participants were divided into two groups. The first group included 20 professional smokers (at least 5 pack/year till the time of study) and the second group consisted of 20 nonprofessional smokers defined as 0.5 pack/ year or less till the time of study. Participants were instructed not to smoke for 6 hours before the study. Patients underwent echocardiography before smoking. The participants were then asked to smoke a whole cigarette. After smoking, echocardiography was repeated within 7 to 15 minutes.Echocardiographic indices of Diastolic function (E wave, A wave, Ea, E/A ratio and deceleration time) were measured before and after smoking.Results: There was no statistically significant difference in the baseline measures in both groups before smoking and also there was no significant difference between measures in the two groups after smoking. The analysis of the pooled data from two groups showed that, smoking resulted in significant increase of heart rate (P<0.001).A wave, E wave, Ea, E/A ratio and deceleration time changed significantly after smoking (P<0.001, P=0.027, P=0.011, P<0.001 and P<0.001 respectively).Conclusion: Smoking of only a cigarette in both professional and nonprofessional smokers, resulted in the same significant Diastolic dysfunction.

Background and purpose: Anthracycline is a topoisomerase-interacting agent that is used in treatment of many cancers. We investigated the effects of anthracycline in adults using conventional echocardiography and pulse tissue Doppler imaging.Materials and methods: This observational before-after study was performed in 35 patients being recently diagnosed with cancer for whom ANT therapy was planned. Echocardiography studies were performed before chemotherapy and 6 months after initiation of the study. Additionally, troponin I and creatinine kinase-MB (CK-MB) were measured one month after the initiation of chemotherapy.Results: Six months after anthracycline therapy, Changes were seen in the systolic and Diastolic left ventricular (LV) function. LV ejection fraction significantly decreased (P<0.001). Additionally, LV end-Diastolic volume, LV end-systolic volume and left atrial diameter significantly increased compared with the baseline measures. According to the tissue Doppler imaging, the mitral annuli early Diastolic (e') velocity significantly reduced, and the E/e' ratio (the peak early Diastolic velocity) significantly increased.Conclusion: Altered LV systolic and Diastolic function was observed after anthracycline chemotherapy.

in a cross - sectional (descriptive and analytic) study on 100 healthy men, the effects of hyerlipidemia on left ventricular Diastolic function was evaluated. The patients aged between 25 and 40 years (mean 31.5+4.41) serum TG level was between 37-769 mg/dl (mean 191.68 + 135.08), total chol level was between 105-355 mg/dl (mean 198.60+47.08),LDL cholesterole ranged between 40.80 and 208.60 mg/dl(mean 117+38.11) HDL cholesterole ranged between 20 and 63 mg/dl (mean 44.15+9.91) The E/A ratio obtained by mitral flow ware in doppler echocardiography was considered a criteria for LV Diastolic performance. In this study, 30% of patients had TG more than 200 mg/dl, 44% had ChoL more than 200 mg/dl .In 63% of patients HDL cholesterole was less than 40 mg/dl and LDL cholesterole was more than 130 mg/dl. in 33% of patients Abnormal E/A ratio(<1.5) was seen in 56% of patients. The relation between TG and ChOI to ElA ratio was significant (P<.005) , P<00012) . In patients with TG>200 mg/dl, the probability of Diastolic dysfunction reaches 4.5 X. with increase of each 37 units of cholesterole level, ElA ratio abnormality should be twice than normal. Correlation coefficience between cholesterole and ElA ratio showed that 12% of LV Diastolic abnormality depends on serum cholesterole level.

Introduction: The overlap syndrome, consisting of obstructive sleep apnea hypopnea syndrome (OSAHS) and chronic obstructive pulmonary disease (COPD) is a major problem in COPD patients. OSHAS corresponds to the likelihood of systemic hypertension. The present study was aimed to evaluate the association between apnea-hypopnea index and Diastolic blood pressure (DBP) in overlap patients.Materials and Methods: We conducted a cross-sectional study involving overnight polysomnography after measurement of resting Diastolic blood pressure (DBP) in patients with overlap syndrome in Sleep Laboratory of Imam Reza Hospital, Mashhad, Iran from November 2010 to July 2012. Participants were divided into four subgroups regarding to their Apnea- Hypopnea Index (AHI) (AHI<5, AHI: 5-15, AHI: 15-30 and AHI>30). Descriptive statistics included age, body mass index (BMI), OSA, Apnea- Hypopnea Index (AHI), DBP, and neck circumference.Results: Sixty participants ranged between from 46 to 82 years old were entered into this study. There was statistically significant difference in mean DBP among different AHI subgroups (80±0.50, 95±0.60, and 105±0.65, respectively) (P<0.001). Additionally, there was statistically significant correlation between AHI and DBP (r=0.60, P=0.01).Conclusion: According to the findings of our study, DBP is an important cardiovascular concern in COPD patients with OSAHS and has a direct correlation with AHI.

Background: Some hypertensive patients experience dyspnea with exercise due to rise in filling pressures. So, exercise is helpful to determine left ventricular filling tension.Objectives: This study aims to evaluate the effect of dobutamine stress echocardiography on Diastolic function in hypertensive patients with normal ejection fraction.Methods: In this study, 30 hypertensive patients (52.7±3.6 years) and 30 sex and age matched healthy controls (50.8±7.6 years) were examined. Exclusion criteria were patients with coronary artery disease, significant valvular heart disease, hypertrophic cardiomyopathy, left ventricular systolic dysfunction (EF (ejection fraction)<50%), atrial fibrillation and bad echogenic view. We performed complete echocardiography and dobutamine stress echocardiography with pulsed wave Doppler tissue imaging at rest and during peak stress to measure primary mitral inflow Diastolic wave rate (E), late mitral inflow Diastolic wave rate (A), E/A ratio, primary Diastolic myocardial wave rate (E0) and late Diastolic myocardial wave velocity (A’).Results: At rest, E’ was significantly lower in patients than controls (8.2±1.6 vs 14.7±2.6 P value<0.001) and E/E (early mitral inflow Diastolic wave rate/early myocardial Diastolic wave rate) was significantly higher in patients (7.6±1.2 vs 4.8±1.0 P value<0.001). At peak stress, E/A ratio was significantly lower in patients (P<0.001) while E/E0 was significantly higher in patients than controls (8.3±2.1 vs 4.7±0.7 P value<0.001).Conclusions: Dobutamine stress echocardiography with Doppler tissue study is effective in the evaluation of hypertensive patients with dyspnea on exertion with normal resting echocardiography.